The document discusses public-private partnerships (PPPs). It defines PPPs as involving a private company borrowing money to build and operate an infrastructure project like a hospital or road for many years, recouping costs and profit through government payments. The document also notes that some governments prefer softer terms than "privatization" when discussing these partnerships. It provides a framework for evaluating PPP proposals against traditional public sector alternatives, finding that PPPs may be more expensive due to higher interest rates and upfront costs, but efficiency in operations is neutral between the models.